N－单甲基左旋精氨酸对犬冠脉内皮依赖性舒张功能及内皮素－1含量的影响

作者在开胸麻醉犬心脏上，观察冠脉内灌注Ｎ－单甲基左旋精氨酸（Ｌ－ＮＭＭＡ）５ｍｇ／ｋｇ，前后冠脉血流动力学、冠脉血流储备（以阻断冠脉１５ｓ再灌注所致的反应性充血血流峰值表示）以及冠脉对不同浓度乙酰胆硷（Ａｃｈ）反应的变化，同时用放射免疫法（ＲＩＡ）测定冠脉前降支（ＬＡＤ）伴行静脉血中的内皮素－１（ＥＴ－１）含量．结果证明，Ｌ－ＮＭＭＡ灌注后心率下降，基础冠脉血流量（ＣＢＦ）下降（χ±ｓ，从２７±６ｍｌ／ｍｉｎ下降至２０±８ｍｌ／ｍｉｎ，Ｐ＜０．０５），冠脉储备下降（χ±ｓ，从９１±１９ｍｌ／ｍｉｎ下降至５０±１０ｍｌ／ｍｉｎ，Ｐ＜０．０１），平均主动脉压升高，ＥＴ－１含量明显升高（χ±ｓ，从６．５±１．０ｎｇ／Ｌ升至１５．５±３．０ｎｇ／Ｌ，Ｐ＜０．０１），Ａｃｈ引起的ＣＢＦ增加减弱（Ｐ＜０．０１）．实验结果提示，生理条件下犬冠脉一氧化氮（ＮＯ）形成对ＣＢＦ，冠脉储备有重要调节作用，同时可抑制冠脉ＥＴ－１释放．     

血清α－L－岩藻糖苷酶活力测定对原发性肝癌的诊断意义

测定了原发性肝癌７７例（ＰＨＣ组），肝硬化３５例（ＤＣ组），消化系统其他恶性肿瘤患者３３例（ＤＳＣ组）及健康人１００例（ＮＣ组）血清α－Ｌ－岩藻糖苷酶（ＡＦＵ）活力。结果表明：ＰＨＣ组ＡＦＵ（６６９．６±１９１．５ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１））显著高于ＮＣ组（３１４．３±６７．０ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１），Ｐ＜０．０１），ＤＳＣ组（３９０．６±１０２．３ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１），Ｐ＜０．０１）和ＤＣ组（４５８．３±１５０．１ｎｍｏｌ·ｍｌ￣（－１）·ｈ￣（－１），Ｐ＜０．０５）。其诊断敏感性和特异性分别为７１．４％和８９．３％，与ＡＦＰ联合检测时ＰＨＣ组总的阳性检出率达８８．２％。     

肾病综合征病人抗氧化功能的研究

为研究肾病综合征（ＮＳ）时抗氧化功能状况，我们测定３６例患者血超氧化物歧化酶（ＳＯＤ）、丙二醛（ＭＤＡ）及维生素Ｅ，以及尿ＳＯＤ、ＭＤＡ。结果表明：ＮＳ患者血总ＳＯＤ、Ｃｕ－Ｚｎ－ＳＯＤ及维生素Ｅ水平明显低于正常对照组（分别为７６．２２±２７．４８μＵ／Ｌ比１０４．２０±１８．８０μＵ／Ｌ，Ｐ＜０．００１；２０．４０±２２．６３μＵ／Ｌ比６２．９９±１５．６０μＵ／Ｌ，Ｐ＜０．００１；６．６８±３．５２ｍｇ／Ｌ比１６．３８±１．０５ｍｇ／Ｌ，Ｐ＜０．００１）；尿ＳＯＤ及ＭＤＡ明显高于对照组（分别为：１１４．９８±３１．７３μＵ／Ｌ比８２．３４±２６．５０μＵ／Ｌ，Ｐ＜０．００１；３．９９±１．９８μｍｏｌ／Ｌ比２．６４±０．７８μｍｏｌ／Ｌ，Ｐ＜０．００１）．研究提示，ＮＳ时抗氧化功能减退，肾脏易遭受氧自由基损害。     

小剂量G—CSF对化疗引起的粒细胞减少症的治疗作用

应用小剂量（２μｇ／ｋｇ）粒细胞集落刺激因子（Ｇ－ＣＳＦ）于１８例肺癌患者化疗中，以观察预防发生中性粒细胞减少症的疗效。其中小细胞肺癌５例，非小细胞肺癌１３例，随机分成Ｇ－ＣＳＦ组及对照组各９例，化疗方案为ＣＥ（卡铂－ＶＰ１６）。结果Ｇ－ＣＳＦ组粒细胞绝对计数（ＡＮＣ）＜２．０×１０９／Ｌ，发生例数５例，持续天数为３．６±３．５天；对照组持续天数１６．８±７．１天，Ｐ＜０．０５。ＡＮＣ最低值至恢复正常（ＡＮＣ＞２．０×１０９／Ｌ）的天数Ｇ－ＣＳＦ组及对照组分别为２．６±１．３天，８．９±５．３天（Ｐ＜０．０５）。Ｇ－ＣＳＦ组化疗后的第２０天ＡＮＣ均已恢复正常，ＡＮＣ为（９．７±６．８）×１０９／Ｌ故可在第２２天顺利接受第二周期化疗。对照组ＡＮＣ（１．６６±０．８）×１０９／Ｌ（Ｐ＜０．０１）。由此可见，小剂量Ｇ－ＣＳＦ能有效地防治肺癌化疗引起的粒细胞减少症     

RP-HPLC测定血浆中奥美拉唑及其相对生物利用度研究

建立了ＲＰ－ＨＰＬＣ快速测定血浆中奥美拉唑的方法，应用该法测定了１０名健康志愿受试者随机交叉单剂量口服奥美拉唑受试片和进口胶囊后的血药浓度，结果表明：两种制剂在人体内的药动学行为均符合一级吸收的开放一室模型，其达峰时间（ｔｍａｘ）分别为（２．６０±０．９４）ｈ和（３．３０±．８２）ｈ；峰浓度（Ｃｍａｘ）分别为（１１７１．０±５５３．２）ｎｇ／ｍｌ和（１２１４．９±５９０．２）ｎｇ／ｍｌ；生物半衰期（ｔ１／２）分别为（０．９５±０．４４）ｈ和（１．０６±０．７３）ｈ；血浓经时曲线下面积（ＡＵＣ）分别为（３６９１．８±２６６５．２）ｎｇ·ｈ／ｍｌ和（３３８７．２±２４０８．７）ｎｇ·ｈ／ｍｌ，配对ｔ检验结果表明，差异均无显著性（Ｐ＞０．０５）。经双单侧ｔ检验，结果显示两者在生物利用度方面属于等效，相对生物利用度为１０８．２３％。     

阿昔洛韦片剂相对生物利用度研究

采用ＨＰＬＣ法研究了１０名男性健康志愿者欠交叉口服由广州南新制药有限公司生产的阿昔收片剂及市售对照药阿昔洛韦片剂后药物在体内的经时过程。结果两药的达峰时间分别为（１．８６４±０．３７７）ｈ和（１．８４８±０．４６３）ｈ，达峰浓度分别为（８６５．２±１４４．２）ｎｇ／ｍｌ和（８７９．２±９５．７）ｎｇ／ｍｌ，ＡＵＣ分别为（５９７８．９±１４２２．２）ｎｇ·ｈ／ｍｌ和（５４００±１１５４．０）ｎｇ·ｈ     

分娩时母婴血清铁蛋白及叶酸含量的观察

本文采用放射免疫法检测２０例临产前孕妇及她们的初生婴儿、血清铁蛋白（ＳＦ）及血清叶酸（ＦＡ）。结果发现婴儿的ＳＦ及ＦＡ均明显高于母亲，其母亲的ＳＦ及ＦＡ几何均值分别为１３．８±４．９ｎｇ／ｍｌ及１．６５±０．６０ｎｇ／ｍｌ。婴儿的ＳＦ及ＦＡ几何均值分别为８８．５±３０．３ｎｇ／ｍｌ及３．９７±１．２３ｎｇ／ｍｌ。两组比较Ｐ〈０．０１，差异有显著意义。但无论是ＳＦ或ＦＡ，母亲、婴儿间无线性关系。     

清热解毒中药对烧伤创面感染大鼠血浆IL－6的水平和TNF诱生量的影响

用黄连、黄柏、黄芩和金银花复方水煎剂治疗烧伤大鼠创面感染，测定血浆中白细胞介素６（ＩＬ－６）的含量和混和淋巴细胞培养上清液中的肿瘤坏死因子ＴＮＦ诱生量。大鼠随机分成假烫组、烧伤创面感染对照组（烧感组）和烧伤创面感染十中药治疗组（中药组）。烧感组和中药组在伤后８、２４和４８ｈ抽血查上述指标。结果示烧伤创面感染的大鼠自烧伤后２４ｈ起血浆ＩＬ－６均高于正常，烫伤后４８ｈ烧感组血浆ＩＬ－６显著高于中药组（Ｐ＜０．０１）。ＴＮＦ的诱生量从伤后２４ｈ起，中药组显著高于烧感组，中药组伤后２４和４８ｈＴＮＦ的诱生量分别为４．２±０．９ｎｇ／ｍｌ和２．６１±１ｎｇ／ｍｌ；烧感组分别为１．１±０．３ｎｇ／ｍｌ和０．９±０．３ｎｇ／ｍｌ（Ｐ＜０．０１）。由此说明抑制内源性致热因子ＩＬ－６和ＴＮＦ的产生是中药清热解毒的重要机制。     

卡托普利心麻液对离体心脏的保存作用

２０只健康家兔随机分为对照组和卡托普利组，每组１０只。采用Ｌａｎｇｅｎｄｏｒｆ灌注兔心模型。对照组单纯用圣托马斯液作为心停跳液和保存液，卡托普利组则在圣托马斯液中加入卡托普利（８０ｍｇ／Ｌ）。离体心脏（供心）于４℃下缺血停跳６ｈ，再灌注３０ｍｉｎ。结果：卡托普利组缺血后心输出量、心肌肌酸磷酸激酶含量、超氧化物歧化酶活性、过氧化脂质含量及六酮前列腺素含量分别为（３２４±２６）ｍｌ／ｍｉｎ、（１８３５±７８）Ｕ／ｇ、（２３２３±６７）Ｕ／Ｌ、（１０５６±１３７）ｎｍｏｌ／ｇ、（０．９５±０．１）ｍｇ／Ｌ；对照组则分别为（２１６±１９）ｍｌ／ｍｉｎ、（９７１±８８）Ｕ／ｇ、（１６０１±７３）Ｕ／Ｌ、（１８７６±３３０）ｎｍｏｌ／ｇ、（０５５±０１）ｍｇ／Ｌ，２组相比均有显著差异（Ｐ＜００１）。提示：卡托普利可明显改善供心心功能，减轻缺血再灌注损伤，为供心的保存提供可能。     

胰岛素抵抗与冠心病关系的初步探讨

本文测定了２０例冠心病患者和１９例正常人葡萄糖耐量（ＯＧＴＴ）时胰岛素和血糖水平。冠心病组ＯＧＴＴ的１、２、３ｈ血清胰岛素为４９．１±１８．９ｍＩＵ／Ｌ、４６．３±１６．４ｍＩＵ／Ｌ３９．６±１５．９ｍＩＵ／Ｌ胰岛素／血糖（ｍＩＵ／ｍｍｏｌ）比值分别为５．１±１．３、５．８±１．１、７．３±１．４，结果均明显高于正常对照组（Ｐ＜０．０１）。表明冠心病组病人存在高胰岛素血症和胰岛素抵抗（ＩＲ）。同时，冠心病组总胆固醇、甘油三酯分别为６．１２±１．８２ｍｍｏｌ／Ｌ、２．４４±１．０６ｍｍｏｌ／Ｌ，均显著高于对照组（Ｐ＜０．０１、Ｐ＜０．０５），提示胰岛素抵抗可能导致脂质代谢紊乱，进而引起冠心病。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.